Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis
Table 5
Sensitivity, specificity, PPV, NPV, and accuracy of different markers in predicting SAP, OF, PNec, need for ICU admission, and mortality.
Sensitivity
Specificity
PPV
NPV
Accuracy
Kappa (95% CI)
Severe acute pancreatitis
Ranson
83.9
78.0
74.3
86.5
80.6
0.61 (0.40–0.75)
Glasgow
71.0
78.0
71.0
78.0
75.0
0.49 (0.27–0.66)
MOSS
77.4
56.1
57.1
76.7
65.3
0.32 (0.10–0.49)
APACHE II
80.6
82.9
78.2
85.0
81.9
0.63 (0.42–0.78)
SIRS
80.6
65.9
64.1
81.8
72.2
0.45 (0.23–0.61)
BISAP
74.2
68.3
63.4
77.8
70.8
0.42 (0.19–0.59)
CTSI
65.4
50.0
54.8
60.9
57.4
0.15 (−0.11–0.39)
IL-6
93.1
96.8
96.4
93.8
95.0
0.90 (0.73–1.0)
CRP
86.2
100
100
88.6
93.3
0.87 (0.70–0.87)
Procalcitonin
86.4
75.0
79.2
83.3
81
0.62 (0.33–0.79)
Organ failure
Ranson
92.0
74.5
65.7
94.6
80.6
0.61 (0.42–0.69)
Glasgow
76.0
74.5
61.3
85.4
75.0
0.48 (0.26–0.64)
MOSS
84.0
55.3
50.0
86.7
65.3
0.34 (0.14–0.46)
APACHE II
96.0
60.9
49.0
97.5
70.8
0.44 (0.30–0.48)
SIRS
84.0
61.7
53.8
87.9
69.4
0.40 (0.20–0.53)
BISAP
80.0
66.0
55.6
86.1
70.8
0.42 (0.20–0.56)
CTSI
65.2
45.5
45.5
65.2
53.6
0.10 (−0.15–0.32)
IL-6
95.7
33.3
78.6
75.0
78.1
0.35 (0.03–0.50)
CRP
82.6
83.8
76.0
88.6
83.3
0.65 (0.42–0.80)
Procalcitonin
100
72.0
70.8
100
83.3
0.68 (0.45–0.68)
Pancreatic necrosis
Ranson
70.6
58.2
34.3
86.5
61.1
0.21 (0.01–0.36)
Glasgow
64.7
63.6
35.5
85.4
63.9
0.22 (0.01–0.39)
MOSS
70.6
45.5
28.6
83.3
51.4
0.11 (−0.07–0.24)
APACHE II
64.7
61.8
34.4
85.0
62.5
0.20 (−0.004–0.37)
SIRS
70.6
50.9
30.8
84.8
55.6
0.15 (−0.04–0.29)
BISAP
58.8
52.7
27.8
80.6
54.2
0.08 (−0.11–0.25)
CTSI
87.5
55.3
45.2
91.3
57.4
0.20 (−0.31–0.36)
IL-6
94.1
72.1
57.1
96.9
78.3
0.55 (0.35–0.61)
CRP
100
81.4
68.0
100
86.7
0.71 (0.53–0.71)
Procalcitonin
78.6
53.6
45.8
83.3
61.9
0.27 (0.003–0.85)
ICU admission
Ranson
88.9
57.1
22.9
97.3
61.1
0.21 (0.45–0.25)
Glasgow
88.9
63.5
25.8
97.6
66.7
0.26 (0.09–0.31)
MOSS
100
47.6
21.4
100
54.2
0.19 (0.06–0.19)
APACHE II
88.9
61.9
25.0
97.5
65.3
0.24 (0.08–0.29)
SIRS
100
52.4
23.1
100
58.3
0.22 (0.09–0.21)
BISAP
77.8
54.0
19.4
94.4
56.9
0.14 (−0.01–0.20)
CTSI
87.5
55.3
45.2
91.3
64.8
0.001 (−0.15–0.12)
IL-6
87.5
59.6
25.0
96.9
63.3
0.23 (0.05–0.29)
CRP
75.0
63.5
24.0
94.3
65.0
0.20 (0.01–0.31)
Procalcitonin
83.3
47.2
20.8
94.4
52.4
0.14 (−0.06–0.21)
Mortality
Ranson
100
58.7
25.7
100
63.9
0.26 (0.12–0.26)
Glasgow
100
65.7
29.0
100
64.4
0.32 (0.16–0.32)
MOSS
100
47.6
21.4
100
54.2
0.19 (0.06–0.19)
APACHE II
100
63.5
28.1
100
68.1
0.30 (0.15–0.30)
SIRS
100
52.4
23.1
100
58.3
0.22 (0.09–0.21)
BISAP
88.9
55.6
22.2
97.2
59.7
0.19 (0.04–0.24)
CTSI
71.4
44.7
16.1
91.3
48.1
0.07 (−0.10–0.16)
IL-6
100
62.7
32.1
100
68.3
0.34 (0.16–0.34)
CRP
66.7
62.7
24.0
91.4
63.3
0.17 (−0.03–0.31)
Procalcitonin
100
51.4
29.2
100
59.5
0.26 (0.07–0.26)
SAP: severe acute pancreatitis, OF: organ failure, PNec: pancreatic necrosis, ICUA: intensive care unit admission, LOHS: length of hospital stay, MOSS: multiple organ system score, APACHE II: acute physiology and chronic health evaluation II, SIRS: systemic inflammatory response syndrome, BISAP: bedside index for severe acute pancreatitis, IL-6; interleukin 6, CRP: C-reactive protein, and CTSI: CT severity index.
